Abstract
In this study, we determined the long-term prevalence of posttraumatic stress disorder (PTSD) in children and adolescents after accidental injury and gained insight into factors that may be associated with the occurrence of PTSD. In a prospective longitudinal study, we assessed diagnosed PTSD and clinically significant self-reported posttraumatic stress symptoms (PTSS) in 90 children (11–22 years of age, 60% boys), 2–4 years after their accident (mean number of months 32.9, SD 6.6). The outcome was compared to the first assessment 3 months after the accident in 147 children, 8–18 years of age. The prevalence of PTSD was 11.6% at first assessment and 11.4% at follow-up. Children with PTSD or PTSS reported significantly more permanent physical impairment than children without. Children who completed psychotherapy had no symptoms or low levels of symptoms at follow-up. Given the long-term prevalence of PTSD in children following accidents, we recommend systematic monitoring of injured children. The role of possible associated factors in long-term PTSS needs further study.
Highlights
Accidents such as traffic accidents, sports accidents and falls are a major cause of pediatric unintentional injury (Brosbe et al 2011; Kassam-Adams et al 2013; van Meijel et al 2015)
The aims of the present study were twofold: (1) to measure the prevalence of posttraumatic stress disorder (PTSD) in children and adolescents, 2–4 years after accidental injury compared with 3 months after the accident; (2) to gain insight into individual factors that are associated with the occurrence of PTSD at followup: permanent physical impairment, acute pain, trauma history and new traumatic events and trauma-focused psychotherapy between the first and follow-up assessment
- Related to accident: Full PTSD: n=3 Partial PTSD: n=1 - Related to new event: Full PTSD: n=1 Partial PTSD: n=2
Summary
Accidents such as traffic accidents, sports accidents and falls are a major cause of pediatric unintentional injury (Brosbe et al 2011; Kassam-Adams et al 2013; van Meijel et al 2015). Children can suffer from posttraumatic stress symptoms following accidents. The majority of the children recover within a few weeks, but if the symptoms persist for more than 1 month and cause significant impairment in one or more areas of functioning, posttraumatic stress disorder (PTSD) can be diagnosed. PTSD negatively affects children’s functioning and physical recovery from injury (Kahana et al 2006; Kassam-Adams et al 2013). Evidence-based psychological treatments for PTSD are available and have proven to be effective in children with multiple types of trauma (Cohen et al 2010; Morina et al 2016; Smith et al 2018).
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